Fee cuts pushing #Ontario doctors to close methadone clinics

The dispute between Ontario doctors and the province over billing rates is threatening access to methadone treatment, with two private Toronto clinics closing their doors and patients in some rural communities facing an uncertain future.

The threat to service follows a 1.3-per-cent rate reduction imposed by the province last month on all fee-for-service billings. The money-saving measures also included targeted reductions, among them a 50-per-cent cut to rates paid to doctors for urine tests that are done once a week or more frequently as part of methadone therapy used to treat heroin and other opioid addictions.

Now at least one Toronto doctor says the fee cut amounts to roughly 25 per cent of his total revenue and means his smaller clinics are losing money. First Nations leaders also are warning access in rural and Northern communities is in danger because private clinics – where most methadone treatment is given – are not as financially attractive. Others say this latest battle over money points to deeper problems with how methadone treatment is delivered in Ontario that go beyond the current billing battle.